Search results for ‘Subject term:"learning disabilities"’ Sort:
Results 1 - 10 of 41
The clinical management and prevention of pica: a retrospective follow-up of 41 individuals with intellectual disabilities and pica
- Authors:
- WILLIAMS Don E., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.210-215.
- Publisher:
- Wiley
Pica is a very dangerous form of self-injurious behaviour because one occurrence can be lethal. This study describes an intervention for people with intellectual disabilities and pica that included comprehensive management of the environment as well as behaviour treatment over a 9-year period. Over a 9-year period, nine surgeries for pica-related incidents occurred prior to intervention; over the 9 years of intervention, pica surgeries were eliminated. Eighty-five percent of participants experienced a 75–100% reduction in pica. Sixteen participants still had restrictive procedures including oral hygiene, overcorrection, contingent personal restraint, contingent mechanical restraint and visual screening with goggles. All continuous mechanical restraint that had been used in baseline was eliminated. People with intellectual disabilities and dangerous pica can be protected on a long-term basis from serious harm if proper management and clinical interventions are both employed. Although restrictive interventions were used on a long-term basis, they were contingent upon a pica incident or pica attempts, which occurred much lower than in baseline sessions. Resident rights were protected throughout the intervention.
Physical interventions for adults with intellectual disabilities: survey of use, policy, training and monitoring
- Authors:
- DEVAU Roy, McGILL Peter
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.145-151.
- Publisher:
- Wiley
Perceived problems around the use of physical intervention (PI) to manage challenging behaviour have led to UK initiatives to encourage policy development and accredited training. However, information on PI use and the impact of these initiatives remains limited. Adult residential services within an English region were sent a questionnaire regarding PI use, policy, staff training and monitoring/management. Physical intervention use was reported by 47% of the services. Of services using PI, 65% reported having a policy governing its use and 79% reported providing staff training. Where restrictive PI was used, comparable figures were 82% for policy and 84% for training. PI use was reported to be monitored in some way by 94% of services. Opinions offered supported the reduction of PI use. Physical intervention use is widespread. National guidance on policy and training is widely followed though unimplemented by a minority. The time may be right to more explicitly aim for a reduction in PI use within services.
Restraint safety: an analysis of injuries related to restraint of people with intellectual disabilities
- Author:
- WILLIAMS Don
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.135-139.
- Publisher:
- Wiley
This American study analysed the use of restraint with 209 individuals with intellectual disabilities exhibiting severely aggressive or self-injurious behaviour over a 12-month period. Planned restraint, the use of restraint as a component of a behaviour treatment programme (i.e. planned personal or planned mechanical restraint) was safer than crisis-intervention restraint (emergency personal or emergency mechanical). The overall rate of injuries during restraint was 0.46 injuries per hundred restraints. Restraint was applied 99.54% of the time without injury. Restraint was relatively safe and safer than reported in one other study. Planned restraint was safer than emergency restraint. The additional training and programme development associated with planned restraint may have contributed to the greater safety of planned restraint. Due to limited empirical data, restraint safety has yet to be established and this study suggests that restraint should be decreased and closely monitored.
Adults with intellectual disabilities: prevalence, incidence and remission of self-injurious behaviour, and related factors
- Authors:
- COOPER S., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(3), March 2009, pp.200-216.
- Publisher:
- Wiley
This study investigates the point prevalence, incidence and remission rates of Self-injurious behaviour (SIB) among the adult population with intellectual disabilities (ID), and explores which factors are independently associated with SIB. A prospective cohort study design was used in a general community setting. The participants were all adults (16 years and over) with ID in a defined geographical area. Individual assessments were conducted with all participants. The point prevalence of SIB (as defined by DC-LD) was 4.9%, the two-year incidence was 0.6%, and two-year remission rate was 38.2%. Independently related to SIB were: lower ability level, not living with a family carer, having attention deficit hyperactivity disorder, visual impairment, and not having Down syndrome. Other factors, including communication impairment, autism, and level of deprivation of the area resided within, were not related. SIB is not as enduring and persistent as previously thought; a significant proportion gains remission in this time period.
Antipsychotic medication and people with intellectual disabilities: their knowledge and experiences
- Authors:
- CROSSLEY Rachel, WITHERS Paul
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(1), January 2009, pp.77-86.
- Publisher:
- Wiley
Antipsychotics are the most frequently prescribed psychotropic medication for people with intellectual disabilities. Many people are prescribed this medication for 'challenging behaviours' without having had a formal diagnosis of a psychiatric disorder. Antipsychotics have been reported to have severe side-effect profiles, which can hamper quality of life. Grounded theory qualitative methodology was employed to organize and analyse data from interviews conducted with eight adults with intellectual disabilities about their experiences of antipsychotic medication. All participants resided in a National Health Service (NHS) domiciliary service for people with an intellectual disability, in community houses in England. Respondents had little knowledge about their medication, beyond knowing their regime. Despite participants experiencing side effects, they were accepting of these effects. A 'model of compliance' was generated from the analysis to capture and reflect ion who people with intellectual disabilities experience medication. The prescription and administration of medication is another area where people with intellectual disabilities experience lack of control and disempowerment. 'Services' need to do more to include and inform people with intellectual disabilities about their medication.
Aggression in intellectual disability - a new approach
- Authors:
- TURNER Katie, CLARKE David
- Journal article citation:
- Mental Health Review Journal, 14(2), June 2009, pp.28-36.
- Publisher:
- Emerald
Aggressive behaviour is a problem for services providing care for people with intellectual disabilities, affecting the quality of life of the individual and the quality of care provided. Current research trends, which focus on risk factors and mental health problems, are discussed. Other factors that could contribute to aggression in people with intellectual disability (PWID), such as lifestyle and environmental issues are examined. A methodology that would allow for the integration of all these factors, Behavioural Sequence Analysis, is a suitable investigative approach to this problem.
Staff stress and people who have mental health needs living in new models of service
- Author:
- ROSE John L.
- Journal article citation:
- Advances in Mental Health and Learning Disabilities, 3(2), June 2009, pp.20-25.
- Publisher:
- Emerald
This paper introduces some of the research that has been conducted into staff stress in learning disability services. It also examines how some individual characteristics of service users, particularly challenging behaviour and mental health problems, may influence the levels of staff stress reported. Service changes as a result of the development of supported living are also considered briefly. Some suggestions are made as to how these changes might influence staff. The importance of new research investigating these developments from a staff perspective is highlighted.
Animals work their magic
- Author:
- -
- Journal article citation:
- Community Care, 27.8.09, 2009, pp.20-21.
- Publisher:
- Reed Business Information
A therapy consultant explains how he was able to enable a boy in his mid-teens diagnosed with learning difficulties to engage with people in meaningful activities and divert him away from offending behaviour. Building on the individual strengths New Forest Care was chosen as a therapy, which provided an opportunity to care for farmyard animals and look after a small holding.
The treatment of challenging behaviour in intellectual disabilities: cost-effectiveness analysis
- Authors:
- ROMEO R., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(7), July 2009, pp.633-643.
- Publisher:
- Wiley
Antipsychotic drugs are used in the routine treatment of adults with intellectual disabilities (ID) and challenging behaviour in the UK despite limited evidence of their effectiveness. There is no evidence on their cost-effectiveness. The relative cost-effectiveness of risperidone, haloperidol and placebo in treating individuals with an ID and challenging behaviour was compared from a societal perspective in a 26-week, double-blind, randomised controlled trial. Outcomes were changes in aggression and quality of life. Costs measured all service impacts and unpaid caregiver inputs. After 26 weeks, patients randomised to placebo had lower costs compared with those in the risperidone and haloperidol treatment groups. Aggression was highest for patients treated with risperidone and lowest for patients treated with haloperidol; however, quality of life was lowest for patients treated with haloperidol and highest for patients treated with risperidone. The authors conclude that the treatment of challenging behaviour in ID with antipsychotic drugs is not a cost-effective option.
Restraint procedures and challenging behaviours in intellectual disability: an analysis of causative factors
- Authors:
- MATSON Johnny L., BOISJOLI Jessica A.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 22(2), March 2009, pp.111-117.
- Publisher:
- Wiley
Persons with intellectual disability often evidence challenging behaviours. Physical/mechanical and chemical restraint and the factors that may result in the use and maintenance of restraint are reviewed. The type, rate and intensity of challenging behaviours, and the age of the affected individual and residential placement appear to be among the major factors that put these persons at risk for restraint. Restraint is still a commonly used intervention employed with people with challenging behaviours. Physical and chemical restraint should be used as a last resort, part of a planned programme, and implemented by trained people.